An infusion preparation containing a sugar, an amino acid, and an electrolyte contained in an infusion bag having two chambers is known and widely used for the nutritional management of patients (see Non-Patent Literature 1).
Adding a reducing sugar and an amino acid to the same solution disadvantageously causes the Maillard reaction and modifies the solution. Therefore, in the infusion preparation, in order to prevent the Maillard reaction caused by a reducing sugar and an amino acid, an infusion containing a reducing sugar is placed in one chamber of an infusion bag, and an infusion containing an amino acid is separately placed in the other chamber. At the time of use, the infusions are mixed by bringing the two chambers into communication with each other and subsequently administered to the patient. In order to facilitate the mixing procedure, the two chambers are generally separated by a partition wall (for example, an easily peelable seal) that can be communicably opened at the time of use. However, there is a case where only one infusion is administered to the patient due to the omission of the communication procedure. Such an error often occurs. Therefore, when such an infusion preparation in a two-chamber container is used, it is very important to ensure that the patient is prevented from being adversely affected even in the case where only one infusion placed in one chamber is administered due to the omission of the communication procedure before use.
For example, when the potassium concentration in one infusion is relatively high, a patient may develop hyperkalemia if this infusion is singly administered thereto. In order to eliminate such a problem, an infusion preparation in which potassium is separately placed into the two chambers and the potassium concentration in each infusion is adjusted to 40 mEq/L or less has been examined (Patent Literature 1).
Further, particularly when an infusion is administered into a peripheral vein, if the osmotic pressure is too high, it may cause vascular pain or phlebitis. Therefore, it is considered to be desirable that an infusion have an appropriate osmotic pressure even before being mixed (Patent Literature 2).
Further, when an infusion preparation containing a sugar, an amino acid, and an electrolyte (a high-calorie infusion preparation) is singly administered for a long period of time, it may induce essential fatty acid deficiency. The development of essential fatty acid deficiency can be prevented by the administration of a fat emulsion in combination with a high-calorie infusion preparation. Further, fat has a high calorific value per weight, and also has advantages such as the fact that, unlike sugar, it does not cause osmotic diuresis. However, when a long time has elapsed after an electrolyte infusion and a fat emulsion were mixed together, the size of fat droplets becomes large, leading to the risk of causing fat embolism when such a mixture is administered. Therefore, an infusion preparation in a two-chamber container in which a fat emulsion and an electrolyte are placed in different chambers and mixed at the time of administration has been developed.
Still further, it is known that acidosis may occur when a vitamin B1 deficiency occurs during the administration of a high-calorie infusion, and vitamin supplementation is required to prevent such a risk when administering a high-calorie infusion. In order to avoid such a problem, a high-calorie infusion preparation comprising three liquids (liquids in large, medium, and small chambers) to which vitamins, in addition to a sugar, an amino acid, and an electrolyte, are added in advance has been developed (for example, the Fulcaliq infusion preparation). The high-calorie infusion preparation is prepared in a form that contains infusions having different compositions in large, medium, and small chambers, in view of problems in the stability of vitamins (particularly fat-soluble vitamins). However, infusion preparations having three chambers require additional work during production and use, thus creating problems with production cost and use. Further, for example, the package insert for the Fulcaliq infusion preparation instructs the user not to mix a fat emulsion as a precaution during preparation.
As described above, techniques that have been examined with respect to various problems are useful in solving the respective problems; however, an infusion preparation that has solved all of the problems was yet to be developed.